New Program Leads to Uptick in Vets Using Private Health Care, but VA Insists It's 'Not Privatizing'

A new initiative to give veterans easier access to private health care is off to a seamless start in its first three months, Trump administration officials told lawmakers on Wednesday, but they said the growth in referrals to non-government doctors is not indicative of any effort to privatize the Veterans Affairs Department. 

VA has scheduled more than 1 million consultations for veterans with private health care providers in the first 90 days since it launched a new community care program under the 2018 Mission Act, Richard Stone, executive in charge of the Veterans Health Administration, told a panel of the House Veterans Affairs Committee. That represented a slight uptick in private sector referrals over what VA had issued prior to implementing the new law, when options for veterans to get non-government appointments were more scattershot and restrictive. 

Stone also noted, however, that in-house appointments at VA have increased by 1.6 million, or 3.1%, in the current fiscal year. While the Mission Act, which Congress passed and President Trump signed last year, enjoyed widespread bipartisan support, it was also enveloped in controversy from detractors who cautioned it would undermine VA’s own  health care network. Some lawmakers who supported the law initially have also criticized VA for the regulations the department issued to implement it.  

“VA is not privatizing, and veterans are choosing VA,” Stone said, noting VHA has grown its own staff in the last year by 13,000.  

More than half the private consults under the Mission Act have been using a new standard—namely doctors and patients decided it was in their “best medical interest.” That factor was at least part of the reason for the referral in about half of the cases and the sole reason in about one-third. About 16,000 veterans have used the new urgent care benefit, which allows them to enter a selection of 6,000 care centers throughout the country without an appointment. 

“We will continue to ensure we meet veterans' needs for care in the years to come,” Stone said. “Our priority remains the integration of veterans' care when and where they need it.” 

While Stone said the “bottom line” is that the Mission Act is a success, Rep. Julia Brownley, D-Calif., who chairs the subcommittee hosting Wednesday’s hearing, noted her staff had conducted “secret shopping trips” and found the Mission Act's systems still have some flaws. The online urgent care locator, for example, pointed veterans to addresses where no facilities existed. Rep. Neal Dunn, R-Fla., added that veterans have complained about long wait times to access community care and providers—both doctors and hospitals—have voiced concerns about slow reimbursements from VA. 

Stone countered that VA is now processing 2 million reimbursements per month, including both direct and contracted work, up from 150,000 just 15 months ago. Jennifer MacDonald, VA’s Mission Act lead, also touted the department’s efforts to educate veterans about their new options, saying it was “at the core of our entire approach” to implementing the law. The department has contacted 9 million veterans with information about the Mission Act through outreach with veterans service organizations, Facebook Live events, brochures, booklets and other materials. 

VA had warned that the Mission Act rollout could be bumpy, with VA Secretary Robert Wilkie telling Congress ahead of the June 6 start date there would be “a few hiccups.” The U.S. Digital Service earlier this year flagged VA’s efforts to launch new tools to support the law as behind schedule and potentially delaying care. To date, however, VA has received mostly positive reviews. 

“I really believe you are the A-team and I believe in you,” Brownley said. She warned, however, that all lawmakers are “going to hear from our veterans locally, and I think that is a pretty good test for how we are doing.” 

MacDonald promised VA would not “rest on its laurels,” but instead continue to push forward to make improvements and ensure the program “can be sustained from here on out.”